Marin Voice: Hope and consequences

ACCORDING to neurologists who had attended to Jani McMath, the Oakland teen has been brain dead since Dec. 12. As I tried to understand the reasoning of Latasha Winkfield, the mother of 13-year-old Jahi (who believes that her daughter can be brought back to life by prayer), I remembered a discussion question I often posed to my bioethics students.

"Consider what would happen if the particular decision you are about to make should become the course of action for everyone, everywhere?"

Stated another way, and applied to Jahi's family, what would be the consequences for society if everyone rejected the accepted medical definition of brain death, the "irreversible ending of brain activity due to the loss of brain oxygenation."

California and most states also define death as the cessation of brainwave activity accompanied by termination of heart and respiratory activity.

According to one bioethicist, "This is not an allowing-to-die case," he said. "There's no choice to be made here. She is gone, and no prayer, no judge, no transfer to a different facility can change that."

Many people are drawing comparisons between brain damaged people who, like the earlier case of Terri Schiavo who had suffered severe brain injury, had been maintained for years in a coma-like, persistent vegetative state.

Unlike Jahi, however, Terri could breathe on her own. She had some brain activity.

After 11 years of care, the courts finally allowed her feeding tube to be removed.

We all sympathize with the trauma faced by Jahi's family who have had to face the awful reality of the death of an otherwise healthy child following routine surgery.

But the question I posed to my students lingers on. Even if we were to accept (for the sake of the argument) the family's belief within their own, unique religious community that God will heal (or resurrect) Jahi from the dead, consider the consequences for the rest of society if more and more people rejected the idea of brain death.

The cost of maintaining a person on "life support" in an intensive care unit or specialized nursing home can cost more than $5,000 per day and can quickly spin out of control.

Since most of the cost of Jahi's care will likely be paid from already limited public health funds, it is surely better health policy to devote that money to helping and healing other sick children rather than spending these dollars on a respirator for a dead person?

Tens of thousands of patients in California are waiting for an organ donation. Surely the best continuance of life for a dead person is the transfer of viable organs to a child who desperately needs them?

Jahi's body was released on Dec. 5 by the Oakland hospital to the Alameda County coroner's office, which then released the body to her mother "as per court order" and taken to a location that has not been disclosed.

Hospital attorney Douglas Straus said, "It's horrible that this child has died. It's also horrible that it's so difficult for her family to accept that death."

Jahi's death was tragic, but surely no more so than the arbitrary and premature deaths of so many other children.

The only moral absolute in cases like Jahi's is that it is better to spend what we have to save actual lives rather than simply prolong the artificial existence of those already dead.

Alan Miller of San Rafael taught bioethics and environmental studies at the University of California at Berkeley for many years.